Dried urine collected across a day
You collect several urine samples on filter paper through a day, following the kit's timing, and you let them dry. The samples leave your house by mail. There is no blood draw for this particular panel. Timing matters: menstruating patients are usually given a cycle window, and the instructions say what to avoid so the day is readable. Dr. Tara Kohen walks through that window before the kit is used.
DUTCH hormone testing is chosen when the question is how hormones are produced and processed across the day, not when the question is an emergency or a single lab value your prescriber already tracks. The kit is an extra cost beyond the visit. FRI does not invent a price in the brochure. You hear the cost before you commit to the kit.
Sex hormones and the metabolites beside them
The report includes estrogen, progesterone, testosterone, and related metabolites, the compounds the body makes as it processes those hormones. A level can look ordinary while the processing pattern is lopsided, or the reverse. Metabolites are why this urine panel can add context a single serum draw does not. They are context, not a verdict that you must take a hormone.
Hormonal imbalance is a broad phrase. The report makes it narrower: which hormone, which metabolite, which part of the day. Perimenopause often brings a changing pattern rather than one low number, and a single morning blood test can miss that change. The review visit is where the pattern is translated into food, sleep, training load, or a conversation with a prescriber.
Cortisol across the day, including the morning
Cortisol is sampled through the day so the curve is visible: a morning rise, a midday level, an evening level. A flat line, a high evening, or a morning that never gets going are different problems and they suggest different next steps. Adrenal fatigue is a phrase patients use for exhaustion. The curve gives something more specific to discuss than that label.
The curve is still not a disease name. Poor sleep, a brutal training week, an infection, or shift work can shape it. Dr. Sani Kohen reads it next to the story of the month you collected, not next to an ideal cartoon. If the month was unusual, the report may need to be repeated later rather than treated as your permanent state.
A home kit, then a review that is a real visit
Results come back after the lab's turnaround, and they are not texted as a list of highs and lows. You sit down and go through the page. The visit often runs 30 to 60 minutes depending on the plan. Questions are expected. A free 20-minute consultation can decide whether DUTCH is the right first lab before any kit is ordered.
Medication and hormone prescriptions stay with the clinician who prescribes them. FRI can show the pattern and coordinate. FRI does not change a dose you were given elsewhere. The office is out of network, accepts HSA and FSA cards, and provides a superbill. The lab fee itself is separate, and you should ask what your card or your plan will do with it before you collect.
What a DUTCH Hormone Testing visit is like
Expect a history first: cycle, sleep, training, stress, and what you hope the test will answer. If the question is vague, the kit waits. If the question is clear, you leave with instructions or a kit and a date to review. Collection is at home. The samples are dried urine, not a jug you carry around all day.
The review is unhurried enough to cover metabolites without rushing you past the words. You should leave knowing what was ordinary, what was worth acting on, and what was noise. Nothing on the page is a diagnosis by itself. Plans that start from a screenshot of someone else's DUTCH are not how this office works.
What we end up working on with Niguel patients
Hill neighborhoods send us knee pain, plantar fasciitis, and low back pain. Desk-plus-commute weeks send neck pain and headaches. Functional movement screening is a plain way to see which basic patterns are limited before they become an injury story. DNS-based exercise is one way we retrain trunk control when the hills expose it.
Parents in these neighborhoods also ask about energy, cycles, and digestion while they are in the car for everyone else's sports. Hormonal imbalance and gut health are separate problems with their own exams. Labs are chosen from the history. Start from the Laguna Niguel chiropractor page if you want the full local map.
Fees and the shape of follow-up
Out of network, superbill, HSA and FSA. Same policy as the rest of the county. We recheck findings instead of assuming a standing weekly visit. If you are better, the gap between visits should grow. If you are not, we change the plan or we say that someone else should see you.
Drs. Sani and Tara Kohen run the practice together. Read about them on the about page. The rooms, including the rehab space, are on the office page. No referral is required from a Laguna Niguel physician, and we will coordinate if you have one.
Master-planned hills, Salt Creek, and Crown Valley traffic
Laguna Niguel is hills and planned neighborhoods: Bear Brand, Kite Hill, the streets above Crown Valley, and the parks along Salt Creek. The walking is rarely flat. Youth sports and weekend rounds of golf share the calendar with freeway jobs north of here. Knees notice the downhills. Low backs notice the car. Necks notice the laptop that follows the commute. We use those specifics in the exam instead of a checkbox that says active.
Salt Creek and the regional park give people a place to walk that is not a treadmill. If walking helps your pain or provokes it, we want to know which path. A loop that is fine on the flat portion and painful on the return grade is a clue, especially for spinal stenosis patterns and for hip pain.
Questions patients ask
Why not just draw blood for hormones?
Blood is a moment. Dried urine across a day shows cortisol's shape and metabolites that one serum draw does not. Blood is still the right tool for some questions, and it is chosen when it is.
Does the report diagnose perimenopause or adrenal fatigue?
No. It adds numbers to the story. The diagnosis, if one is used, comes from the full picture, and some labels patients arrive with are not formal diagnoses at all.
Will you change my hormone prescription from this test?
No. Prescribing and dose changes belong to the prescriber. The visit can inform that conversation. It does not replace it.
Is the lab fee included in the visit?
No. The kit is an additional cost. You are told that before you order, without a made-up price list in the explanation.
Related methods and problems for Laguna Niguel
DUTCH Hormone Testing is one tool inside Functional Medicine. It is not booked as a standalone trick disconnected from the exam. These links are the neighboring methods and the problems that most often lead someone from Laguna Niguel to ask about it.
- DUTCH Hormone Testing overview
The clinic-wide technique page, without a city attached.
- Laguna Niguel chiropractor
Drive, neighborhoods, and the rest of the care offered to Laguna Niguel patients.
- Functional Medicine
The pillar this method belongs to.
- Thyroid Panel
A thyroid panel at Functional Restoration Institute can include TSH, free T4, free T3, reverse T3, and antibodies. Each one answers a.
- Advanced Bloodwork
Advanced bloodwork goes past a bare metabolic panel when the question needs more context. Lipids in more detail, glucose with insulin, iron.
- Nutrition & Supplementation
Nutrition at Functional Restoration Institute starts with food. A supplement is added only when a lab or a clear clinical question calls.
- Functional Lab Testing
Functional lab testing is the visit where the history chooses a lab, instead of a cart of kits. DUTCH, a GI-MAP stool.
- Hormonal Imbalance in this city
Hormone symptoms rarely live in one gland. Cycle changes, thin sleep, temperature swings, and uneven energy often reflect how sex hormones, cortisol,.
